Diabetes is widely recognized as one of the leading causes of death and disability. Medical complications from diabetes can cause blindness, heart disease, stroke, kidney failure, nerve damage, and amputations. The Diabetes Control and Complications Trial researched the effect of intensive treatment on insulin dependent diabetics. This study concluded that intensive treatment significantly reduces the number of complications that diabetics suffer. This intensive treatment roughly doubles the $2,000 annual cost of treating each diabetic. We propose to test a portable telecommunicating glucose monitor which automatically transmits patient's glucose data -- via telephone lines -- to their physician. This system will improve the efficiency of patient to physician communications; providing a method of and direct feedback. Phase l has three tasking areas: (l) recruitment and training, (2) pilot study, and (3) data analysis and documentation. The aim of the pilot study is to measure the effects this device has on diabetic patient care, determine reliability, compliance and acceptability with patients and to collect feedback. A qualified team consisting of two M.D.'s and two M.S. biomedical engineers will pursue this task. The successful investigation will lead to a complete glucose monitoring system that can reduce costs associated with intensive treatment. PROPOSED COMMERCIAL APPLICATION: Our goal is to show that automatically telecommunicating diabetic patient's glucose data to the physician can reduce the cost of diabetic care while improving the quality of care. This technology is aimed at physicians who will use it as a tool to initiate tight-control, assist tight-control, reinforce compliance or to assist diabetes research.